Updated August 19, 2015.
Platelets are the small cells in your body that stick to the wall of a blood vessel following injury. They clump together and prevent bleeding. If you have low platelets in your blood, or thrombocytopenia, your ability to form clots and stop bleeding may be impaired. Therefore, there are some things you should know about living with low platelets.
What Causes Low Platelets (Thrombocytopenia)?:
Thrombocytopenia may be caused by the effects of chemotherapy or radiation therapy on your bone marrow.
As you may already know, these therapies are unable to tell the difference between cancer cells and healthy cells. They can kill any cell, but especially target cells that reproduce quickly such as those in your bone marrow. Your treatment may unintentionally kill the cells in your marrow that are dedicated to producing platelets.
Another cause of thrombocytopenia may be the effect of your blood cancer itself on the marrow. If the marrow is invaded by cancer cells, the healthy cells may get “crowded out” by the cancer cells and this may affect the production of blood cells such as platelets.
Symptoms of Low Platelets:
If you have a low platelet count, here are some symptoms you may experience:
- Easy bruising
- Excessive bleeding following even minor injuries
- Pain in your joints
- Blood in the white parts of your eyes, or changes in vision
- Blood in your urine, vomit, or bowel movements
- Tiny little red spots on your skin called “petechiae”
- Frequent nose bleeds
- Bleeding gums
- Headaches
Managing of Low Platelets:
In the meantime, there are things you can do to avoid complications from low platelets:
- Avoid medications that contain aspirin or blood thinners, unless your healthcare professional recommends otherwise. Ask your pharmacist if you are unsure
- Use an electric razor to shave
- Use extra care when using sharp objects such as knives or scissors
- Avoid contact sports
- Use an extra- soft toothbrush and do frequent mouth care
- Avoid flossing when your platelet count gets very low
- Blow your nose gently
- Limit or avoid drinking alcohol
What to Do If Bleeding Starts:
- Have a seat or lie down. Try to remain calm
- Apply pressure to the wound if you can see it
- Apply an ice pack to the site to slow the bleeding
- If the wound is on an arm or leg, elevate the limb above the level of your heart
- If you notice blood in your urine, keep drinking increased fluids and report to your doctor
- If you notice blood in your vomit, take your antinausea and stomach antacids as directed by your doctor
- If you are bleeding vaginally or having your period, do not use tampons. Keep track of how many sanitary pads you are using and note any clots
When to Call the Doctor:
It is important to call your healthcare provider if you have:
- Headache, confusion or dizziness
- Blood when you cough, or difficulty breathing
- Bloody urine, vomit, or bowel movements
- Vaginal bleeding after menopause OR unusually heavy vaginal bleeding
Treatment of Low Platelets
Usually, thrombocytopenia will resolve on its own once your bone marrow recovers from treatment and your cancer is in better control. Meanwhile, you may need to have transfusions of platelets to prevent complications from bleeding.
If this is the case, you can expect to receive the platelets through an infusion into your vein.
The Bottom Line:
Low platelets, or thrombocytopenia, are a common side effect of blood cancers and their treatment. As a result, you may experience frequent or excessive bleeding. It is important to do your best to avoid injury to prevent complications from occurring.
Sources
Pruett, J. Bleeding in Yarbro, C., Frogge, M., and Goodman, M. eds. (1999) Cancer Symptom Management 2nd ed. Jones and Bartlett: Sudbury MA